Heather Nelson is from Spring Hill, Kansas. While at the KU School of Nursing Heather received the Visiting Nurse Association Scholarship for 2010. For 2011 she received the Hagen Student Opportunity Award, the Sara Patterson Award, and was a nominee for the KUMC Student Leadership Award. Her clinical excellence was recognized with an honorable mention for the coveted Clinical Medical Surgical Excellence in 2010. In 2011 she received the equally prestigious Level III Clinical Excellence Award for her work during her critical care clinical. She is the author of “From scrubs to stairs: The innovation of nursing excellence” published in the April/May 2011 edition of Imprint, The Journal for the National Student Nurses Association and was a key note speaker at the NSNA 2011 National Convention on “Climbing your staircase: Crafting your own transformational ideal nurse practitioner”.

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The purpose of this paper is to examine adolescents’ ability to make competent decisions, and explore the legal and ethical ramifications surrounding the use of Pediatric Advance Directives. Evidence strongly supports that adolescents living with terminal illness meet the definition of competency in regards to making health care decisions, including the decision to forego medical treatments that merely extend their pain and suffering and prolong their inevitable death—but where does the law stand? As nurses, it is our duty to advocate for our patients’ autonomy. We can collaborate with families to provide care for their dying loved one in a way that is respectful of their wishes and avoid the turmoil lived by adolescents such as C.G. Nurses can be instrumental in becoming a voice for these voiceless minors by advocating at the bedside with families, and at the systems level for change in the current Patient Self-Determination Act to include advance directives for competent adolescents.

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UNIVERSITY OF KANSAS SCHOOL OF NURSING BACHELOR OF SCIENCE IN NURSING PROGRAM AND DELTA CHAPTER OF SIGMA THETA INTERNATIONAL